MANILA, Philippines – A devout Catholic, former President Gloria Macapagal-Arroyo finds it difficult even to swallow a Communion host.
This is because Mrs Arroyo often chokes due to a previous operation, said her latest medical report that was submitted to the Pasay Regional Trial Court (RTC) Branch 112 last week. Her physician at the Makati Medical Center (MMC), Dr Roberto Anastacio, described this condition as life-threatening.
Reports on Mrs Arroyo's supposedly life-threatening condition resurfaced in May, when an anonymous source told the Philippine Daily Inquirer that the former President was complaining of a choking sensation “due to the titanium implant that has protruded to her esophagus.” (Read: Arroyo needs another surgery?)
The official report on Mrs Arroyo's medical condition, which was submitted by the Veterans Memorial Medical Center (VMMC), included the diagnosis of MMC's Anastacio. The private doctor said Mrs Arroyo reported, among other things, "difficulty in swallowing food, including Communion host and medicine."
Mrs Arroyo, who is under hospital arrest at the VMMC, visited Anastacio in MMC for further tests in May. Doctors from the VMMC accompanied the former President.
Anastacio's report detailed how Mrs Arroyo's titanium implant, which she got in July 2011, caused her current condition. Fitted in her spine at the St Luke's Medical Center, the titanium implant had caused complications in the past. (Read: Spinal surgery and titanium plates.)
Now, the titanium implant is exerting pressure on Mrs Arroyo's hypopharynx, the bottom part of the pharynx or throat, which connects the nose and mouth to the esophagus.
The purpose of the hypopharynx is “to guide food and saliva past the voicebox, and into the esophagus where they travel to the stomach,” said a primer from the Lahey Clinic, a Tufts University School of Medicine teaching hospital.
Pressure from the titanium implant is therefore making it difficult for Mrs Arroyo to swallow, said Anastacio.
The titanium implant is also exerting pressure on Mrs Arroyo's vagus nerve. This nerve, according to MedicineNet.com, “supplies nerve fibers to the pharynx (throat), larynx (voice box), trachea (windpipe), lungs, heart, esophagus, and intestinal tract.”
Likewise, Mrs Arroyo's implant is putting pressure on the vagus nerve's branch, the recurrent laryngeal nerve “that is very important in relation to swallowing, (to) breathing, and obviously to life,” Anastacio said.
In his report, Mrs Arroyo's private doctor thus wrote: “The patient symptoms (sic) of swallowing difficulty with choking sensation postoperatively is a dangerous sign against life because of the following:
Anastacio, then, “seriously” suggested Mrs Arroyo should seek “an opinion in (a) hospital whose expertise is purely repeat reconstructive neuro-cervical surgery.”
In May, the Inquirer's anonymous source said Mrs Arroyo might need a surgery abroad to remedy her condition.
Meanwhile, the VMMC Rehabilitation Medicine Department made its own evaluation of Mrs Arroyo's condition for the month of May.
“During this period, our patient has no additional complaints aside from the previously mentioned attacks of intermittent neck and back pains,” said the VMMC's Dr Rafaelita Javier in Mrs Arroyo's medical report.
Based on the Pain Analogue Scale, the severity of Mrs Arroyo's complaints ranges from 8-9/10 to 3/10. Under the scale, 10 is the most severe.
In a separate progress report, the VMMC reported the former President's complaints “of more frequent choking sensation during mealtime, which is relieved by proper swallowing exercises.”
Photo by Paterno Esmaquel II
The former President also says prolonged sitting aggravates her back pain while rest relieves it, Javier added. She is, however, able to do daily chores.
“Although her neck range of motion is limited, she is functionally independent with regard (to the) performance of the activities of daily living,” said Javier, referring to actions like mobility, bathing, grooming, eating, and using the toilet.
The VMMC said Mrs Arroyo needs “continuation of daily sunlight exposure, continuation of physical therapy every other day, monitoring of blood pressure, and continuation of present medications.”
The state-run hospital prescribes 16 different types of medication, 10 of which she needs to take daily. (Read the full VMMC report with the MMC attachment below.)
It is up to the Commission on Elections (Comelec), which filed an electoral sabotage case against Mrs Arroyo, to request Pasay RTC Branch 112 to remove the former President from hospital arrest.
Comelec legal department head Esmeralda Ladra, however, said their camp has not discussed such possible motion. Ladra said Comelec is prioritizing the requirements to oppose Mrs Arroyo's bail petition, which is pending before the court.
Mrs Arroyo's critics fear the court will grant her bail due to the quality of evidence against her. (Read: Arroyo bail feared due to 'rushed' case.)
Senate President Juan Ponce Enrile, for his part, warned against putting Mrs Arroyo in a regular jail. “What if she dies in jail? How would it look like to the rest of the world when you put a former president in jail together with (common criminals)?” Enrile said in a radio interview.
The Palace is leaving it to the Pasay RTC to decide on Mrs Arroyo's arrest, said Deputy Presidential Spokesperson Abigail Valte in another interview. “We have always been in the position that due respect should be accorded to the former President because of her health condition,” Valte said.
Earlier, Presidential Spokesperson Edwin Lacierda said Mrs Arroyo should be transferred to a regular cell "if everything is well with her." "Hospital arrest should not be used as a basis to feign illness," Lacierda said. – Rappler.com
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Paterno R. Esmaquel II, news editor of Rappler, specializes in covering religion and foreign affairs. He obtained his MA Journalism degree from Ateneo and later finished MSc Asian Studies (Religions in Plural Societies) at RSIS, Singapore. For story ideas or feedback, email him at firstname.lastname@example.org.